Melioidosis, an infection due to Burkholderia pseudomallei, is endemic in southeast Asia and northern
Australia. We reviewed our experience with meropenem in the treatment of severe melioidosis in 63 patients
over a 6-year period. Outcomes were similar to those of ceftazidime-treated patients (n 153) despite a
deliberate selection bias to more-unwell patients receiving meropenem. The mortality among meropenemtreated
patients was 19%. One patient had a possible drug fever associated with the use of meropenem. We
conclude that meropenem (1 g or 25 mg/kg every 8 h intravenously for >14 days) is an alternative to
ceftazidime and imipenem in the treatment of melioidosis. The use of meropenem may be associated with
improved outcomes in patients with severe sepsis associated with melioidosis.